A Study to Evaluate Safety, Tolerability, and Preliminary Effect of the GEN1053 Antibody on Malignant Solid Tumors as Monotherapy
- Registration Number
- NCT05435339
- Lead Sponsor
- Genmab
- Brief Summary
The drug that will be investigated in the study is GEN1053. GEN1053 is an antibody designed to (re)activate and increase antitumor immunity.
Since this is the first study of GEN1053 in humans, the main purpose is to evaluate safety. Besides safety, the study will determine the recommended GEN1053 dose to be tested in a larger group of participants and assess preliminary clinical activity of GEN1053.
GEN1053 will be studied in a broad group of cancer patients, having different kinds of solid tumors. All participants will get GEN1053. The study consists of two parts: Part 1 tests increasing doses of GEN1053 ("escalation"), followed by Part 2 which tests the recommended phase 2 dose GEN1053 dose from Part 1 ("expansion").
- Detailed Description
The trial is a First in Human open-label, multicenter, multinational safety trial in participants with non-central nervous system (non-CNS) metastatic or advanced malignant solid tumors for whom there is no available standard therapy likely to confer clinical benefit, evaluating the safety, tolerability, preliminary antitumor activity, pharmacokinetics (PK), pharmacodynamics (PD), and immunogenicity of GEN1053.
The trial will be conducted as follows:
* The Dose Escalation part (Part 1) will explore the safety of escalating doses of GEN1053 as monotherapy (phase 1)
* The Expansion part (Part 2) is planned to provide additional safety and initial antitumor activity information of the Recommended Phase 2 dose (RP2D) for GEN1053 monotherapy in selected tumor indications, as well as more detailed data related to the mode of action (MoA).
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 31
For both the Dose Escalation and Expansion parts:
- Be ≥18 years of age.
- Have measurable disease according to RECIST 1.1
- Provide all pre-baseline scans since failure of last prior therapy (ie radiographic PD), if available
- Have Eastern Cooperative Oncology Group performance status ≤1.
- Have organ and bone marrow function as follows:
Bone marrow / hematological function:
- Absolute neutrophil count (ANC) ≥1.5×10^9/L
- Hemoglobin ≥9.0 g/dL
- Platelet count ≥150×10^9/L
Liver function:
- Total bilirubin ≤ upper limit of normal (ULN)
- Alanine aminotransferase ≤1.5×ULN
- Aspartate aminotransferase ≤1.5×ULN
- Albumin ≥30 g/L
Coagulation status:
- Prothrombin time (PT)/International normalized ratio ≤1.5
- Activated partial thromboplastin time (aPTT) ≤1.5×ULN
- Renal function: Glomerular filtration rate ≥45 mL/min/1.73 m², according to the abbreviated Modification of Diet in Renal Disease equation
For Monotherapy Dose Escalation (phase 1) only:
- Subjects with histologically or cytologically confirmed non-CNS solid tumors that are metastatic or advanced.
- Subjects who have progressed on standard of care therapy or for whom there is no available standard therapy likely to provide clinical benefit, or who are not candidates for or refuse such available therapy, and for whom, in the opinion of the investigator, experimental therapy with GEN1053 may be beneficial.
- Fresh biopsies mandatory for all patients in Monotherapy Dose Escalation
For the Expansion part Only:
•Subjects with histologically or cytologically confirmed diagnosis of recurrent, unresectable or metastatic HNSCC, who have progressed on standard of care therapy or do not have any further available standard therapy or are not candidates for or refuse standard therapy (if subjects had access), and for whom experimental therapy with GEN1053 may be beneficial in the opinion of the investigator.
Key Exclusion Criteria (all parts):
-
Has uncontrolled intercurrent illness, including but not limited to:
- Ongoing or active infection requiring IV treatment with anti-infective therapy administered less than 2 weeks prior to first dose.
- Symptomatic congestive heart failure (Grade III or IV as classified by the New York Heart Association), unstable angina pectoris or cardiac arrhythmia.
- Uncontrolled hypertension defined as systolic blood pressure ≥160 mm Hg and/or diastolic blood pressure ≥100 mm Hg, despite optimal medical management.
- Prolonged QTc interval at baseline of ≥470 milliseconds using Fridericia's QT correction formula.
- Ongoing or recent (within 1 year) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk for irAEs.
- History of grade 3 or higher irAEs that led to treatment discontinuation of a CPI.
- History of chronic liver disease or evidence of hepatic cirrhosis.
- Evidence of interstitial lung disease.
- Ongoing pneumonitis or history of non-infectious pneumonitis that has required steroids.
- Known platelet function defects
-
Prior therapy:
- Radiotherapy within 14 days prior to first GEN1053 administration. Palliative radiotherapy will be allowed.
- Treatment with an anti-cancer agent (within 28 days or after at least 5 half-lives of the drug, whichever is shorter), prior to GEN1053 administration.
- Subject with a condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of first treatment. Inhaled or topical steroids, and adrenal or pituitary replacement steroid > 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease.
NOTE: Other protocol defined Inclusion/Exclusion criteria may apply
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description GEN1053 Monotherapy GEN1053 -
- Primary Outcome Measures
Name Time Method Number of Participants With Dose Limiting Toxicities (DLTs) Day 1 up to Day 21 The occurrence of any of the following toxicities, assessed as related to trial treatment, were considered DLTs: All Grade 5 events, Grade 4 anaphylaxis, infusion-related reactions and neutropenia for ≥7 days, Grade 3/4 febrile neutropenia, Grade 4 thrombocytopenia, Grade 3 thrombocytopenia with clinically significant bleeding, Grade 4 anemia, Grade 4 aspartate aminotransferase (AST), alanine aminotransferase (ALT), or bilirubin elevation/Grade 3 that did not recover to ≤Grade 1 within 14 days, AST or ALT elevations ≥Grade 2 with concomitant bilirubin \>2.0×upper limit of normal with no signs of cholestasis, any Grade 4 immune-related adverse event (irAE), Grade 3 irAEs that did not improve to ≤Grade 1 within 7 days (with exceptions), Grade 4 cytokine release syndrome (CRS), Grade 3 CRS not resolved to ≤Grade 2 within 48 hrs following adequate intervention, any other ≥Grade 3 nonhematological adverse event (AE) during the first GEN1053 treatment cycle (with exceptions), cycle=3 weeks.
Number of Participants With At Least One Treatment-emergent Adverse Event (TEAE) Up to approximately 1.5 years An adverse event (AE) was any untoward medical occurrence in a participant or clinical trial participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE was therefore any unfavorable and unintended sign (including an abnormal safety laboratory parameter finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product. A TEAE was defined as an AE occurring or worsening after first dose. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.
- Secondary Outcome Measures
Name Time Method Volume of Distribution (Vz) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing concentrations of GEN1053.
Predose Trough Concentration (Ctrough) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing concentrations of GEN1053.
Clearance (CL) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing the pharmacokinetics (PK) of GEN1053.
Maximum (Peak) Concentration (Cmax) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing concentrations of GEN1053.
Time to Maximum (Peak) Concentration (Tmax) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing concentrations of GEN1053.
Elimination Half-life (t1/2) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing concentrations of GEN1053.
Area Under the Concentration-time Curve (AUC) From Time Zero to Last Quantifiable Measurement (AUClast) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing concentrations of GEN1053.
AUC From Time Zero Over the Dosing Interval (AUCtau) of GEN1053 Cycle 1 and Cycle 3 (cycles were 3 weeks) Venous blood samples were collected for analyzing concentrations of GEN1053.
Number of Participants With Anti-drug Antibodies (ADAs) to GEN1053 Cycle 1 Day 1 through end of safety follow up (60 days after last dose [cycles were 3 weeks]), up to approximately 1.5 years Venous blood samples were drawn for analysis of ADAs in serum samples.
Objective Response Rate (ORR) Up to approximately 1.5 years ORR was defined as the number of participants with best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) (ie, "responders"), as per local review and according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. CR was defined as all of the following: disappearance of all target and non-target tumor lesions, and reduction in short axis to \<10 millimeters (mm) in all pathological target and non-target lymph nodes, and normalization of tumor marker level (if applicable). PR was defined as ≥30 percent (%) decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Data are presented for the number of participants with ORR.
Disease Control Rate (DCR) Up to approximately 1.5 years DCR was defined as the number of participants with CR, PR, or stable disease (SD). CR was defined as all of the following: disappearance of all target and non-target tumor lesions, and reduction in short axis to \<10 mm in all pathological target and non-target lymph nodes, and normalization of tumor marker level (if applicable). PR was defined as ≥30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking as reference the smallest sum diameters (nadir) while on study. Data are presented for the number of participants with DCR.
Duration of Response (DOR) Up to approximately 1.5 years DOR was defined as the time from the first documentation of objective tumor response (CR or PR) to the date of first PD or death due to any cause in participants whose confirmed BOR was CR or PR.
Trial Locations
- Locations (5)
Clinica Universidad de Navarra
🇪🇸Pamplona, Navarra, Spain
Sarah Cannon Research Institute
🇺🇸Nashville, Tennessee, United States
Yale University
🇺🇸New Haven, Connecticut, United States
Centro Integral Oncologico Clara Campal
🇪🇸Madrid, Spain
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain